Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery

Tanner, Judith and Kiernan, Martin and Hilliam, R. and Davey, S. and Collins, E. and Wood, T. and Ball, J. and Leaper, David (2016) Effectiveness of a care bundle to reduce surgical site infections in patients having open colorectal surgery. Annals of the Royal College of Surgeons of England, 98 (4). pp. 270-274. ISSN 1478-7083

[img]
Preview
PDF - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Download (206kB) | Preview

Abstract

Introduction

In 2010 a care bundle was introduced by the Department of Health (DH) to reduce surgical site infections (SSIs) in England. To date, use of the care bundle has not been evaluated despite incorporating interventions with resource implications. The aim of this study was to evaluate the DH SSI care bundle in open colorectal surgery.

Methods

A prospective cohort design was used at two teaching hospitals in England. The baseline group consisted of 127 consecutive patients having colorectal surgery during a 6-month period while the intervention group comprised 166 patients in the subsequent 6 months. SSI and care bundle compliance data were collected using dedicated surveillance staff.

Results

Just under a quarter (24%) of the patients in the baseline group developed a SSI compared with just over a quarter (28%) in the care bundle group (p>0.05). However, compliance rates with individual interventions, both before and after the implementation of the bundle, were similar. Interestingly, in only 19% of cases was there compliance with the total care bundle. The single intervention that showed an associated reduction in SSI was preoperative warming (p=0.032).

Conclusions

The DH care bundle did not reduce SSIs after open colorectal surgery. Despite this, it is not possible to state that the bundle is ineffective as compliance rates before and after bundle implementation were similar. All studies evaluating the effectiveness of care bundles must include data for compliance with interventions both before and after implementation of the care bundle; poor compliance may be one of the reasons for the lower than expected reduction of SSIs.

Item Type: Article
Keywords: Colorectal surgery; Surgical site infection; Care bundle; Compliance
Schools/Departments: University of Nottingham, UK > Faculty of Medicine and Health Sciences > School of Health Sciences
Identification Number: https://doi.org/10.1308/rcsann.2016.0072
Depositing User: Roe, Jonathan
Date Deposited: 05 Apr 2018 08:08
Last Modified: 05 Apr 2018 08:14
URI: http://eprints.nottingham.ac.uk/id/eprint/50774

Actions (Archive Staff Only)

Edit View Edit View